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Research Article
6 June 2024

How Hearing Loss and Cochlear Implantation Affect Verbal Working Memory: Evidence From Adolescents

Publication: Journal of Speech, Language, and Hearing Research
Volume 67, Number 6
Pages 1850-1867

Abstract

Purpose:

Verbal working memory is poorer for children with hearing loss than for peers with normal hearing (NH), even with cochlear implantation and early intervention. Poor verbal working memory can affect academic performance, especially in higher grades, making this deficit a significant problem. This study examined the stability of verbal working memory across middle childhood, tested working memory in adolescents with NH or cochlear implants (CIs), explored whether signal enhancement can improve verbal working memory, and tested two hypotheses proposed to explain the poor verbal working memory of children with hearing loss: (a) Diminished auditory experience directly affects executive functions, including working memory; (b) degraded auditory inputs inhibit children's abilities to recover the phonological structure needed for encoding verbal material into storage.

Design:

Fourteen-year-olds served as subjects: 55 with NH; 52 with CIs. Immediate serial recall tasks were used to assess working memory. Stimuli consisted of nonverbal, spatial stimuli and four kinds of verbal, acoustic stimuli: nonrhyming and rhyming words, and nonrhyming words with two kinds of signal enhancement: audiovisual and indexical. Analyses examined (a) stability of verbal working memory across middle childhood, (b) differences in verbal and nonverbal working memory, (c) effects of signal enhancement on recall, (d) phonological processing abilities, and (e) source of the diminished verbal working memory in adolescents with cochlear implants.

Results:

Verbal working memory remained stable across middle childhood. Adolescents across groups performed similarly for nonverbal stimuli, but those with CIs displayed poorer recall accuracy for verbal stimuli; signal enhancement did not improve recall. Poor phonological sensitivity largely accounted for the group effect.

Conclusions:

The central executive for working memory is not affected by hearing loss or cochlear implantation. Instead, the phonological deficit faced by adolescents with CIs denigrates the representation in storage and augmenting the signal does not help.

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References

AuBuchon, A. M., Pisoni, D. B., & Kronenberger, W. G. (2015). Short-term and working memory impairments in early-implanted, long-term cochlear implant users are independent of audibility and speech production. Ear and Hearing, 36(6), 733–737.
AuBuchon, A. M., Pisoni, D. B., & Kronenberger, W. G. (2019). Evaluating pediatric cochlear implant users' encoding, storage, and retrieval strategies in verbal working memory. Journal of Speech, Language, and Hearing Research, 62(4), 1016–1032.
Baddeley, A. D. (1966). Short-term memory for word sequences as a function of acoustic, semantic and formal similarity. Quarterly Journal of Experimental Psychology, 18(4), 362–365.
Baddeley, A. D. (2012). Working memory: Theories, models, and controversies. Annual Review of Psychology, 63(1), 1–29.
Baddeley, A. D., & Hitch, G. J. (1974). Working memory. In G. Bower (Ed.), The psychology of learning and motivation: Advances in research and theory (pp. 47–89). Academic Press.
Baddeley, A. D., & Hitch, G. J. (2019). The phonological loop as a buffer store: An update. Cortex, 112, 91–106.
Baumann, J. F., & Graves, M. F. (2010). What is academic vocabulary? Journal of Adolescent & Adult Literacy, 54(1), 4–12.
Beer, J., Kronenberger, W. G., Castellanos, I., Colson, B. G., Henning, S. C., & Pisoni, D. B. (2014). Executive functioning skills in preschool-age children with cochlear implants. Journal of Speech, Language, and Hearing Research, 57(4), 1521–1534.
Bharadwaj, S. V., Maricle, D., Green, L., & Allman, T. (2015). Working memory, short-term memory and reading proficiency in school-age children with cochlear implants. International Journal of Pediatric Otorhinolaryngology, 79(10), 1647–1653.
Burkholder, R. A., & Pisoni, D. B. (2003). Speech timing and working memory in profoundly deaf children after cochlear implantation. Journal of Experimental Child Psychology, 85(1), 63–88.
Campbell, R., & Dodd, B. (1980). Hearing by eye. Quarterly Journal of Experimental Psychology, 32(1), 85–99.
Castellanos, I., Kronenberger, W. G., Beer, J., Colson, B. G., Henning, S. C., Ditmars, A., & Pisoni, D. B. (2015). Concept formation skills in long-term cochlear implant users. Journal of Deaf Studies and Deaf Education, 20(1), 27–40.
Classon, E., Rudner, M., & Ronnberg, J. (2013). Working memory compensates for hearing related phonological processing deficit. Journal of Communication Disorders, 46(1), 17–29.
Cleary, M., Pisoni, D. B., & Geers, A. E. (2001). Some measures of verbal and spatial working memory in eight- and nine-year-old hearing-impaired children with cochlear implants. Ear and Hearing, 22(5), 395–411.
Conrad, R., & Hull, A. J. (1964). Information, acoustic confusion and memory span. British Journal of Psychology, 55(4), 429–432.
Conway, C. M., Pisoni, D. B., & Kronenberger, W. G. (2009). The importance of sound for cognitive sequencing abilities: The auditory scaffolding hypothesis. Current Directions in Psychological Science, 18(5), 275–279.
Cowan, N. (2014). Working memory underpins cognitive development, learning, and education. Educational Psychology Review, 26(2), 197–223.
Coxhead, A. (2000). A new academic word list. TESOL Quarterly, 34(2), 213–238.
Crowder, R. G. (1983). The purity of auditory memory. Philosophical Transactions of the Royal Society of London Series B-Biological Sciences, 302(1110), 251–265.
Davidson, L. S., Geers, A. E., Hale, S., Sommers, M. M., Brenner, C., & Spehar, B. (2019). Effects of early auditory deprivation on working memory and reasoning abilities in verbal and visuospatial domains for pediatric cochlear implant recipients. Ear and Hearing, 40(3), 517–528.
de Gelder B., & Vroomen, J. (1992). Abstract versus modality-specific memory representations in processing auditory and visual speech. Memory & Cognition, 20(5), 533–538.
Figueras, B., Edwards, L., & Langdon, D. (2008). Executive function and language in deaf children. Journal of Deaf Studies and Deaf Education, 13(3), 362–377.
Geers, A. E., Pisoni, D. B., & Brenner, C. (2013). Complex working memory span in cochlear implanted and normal hearing teenagers. Otology & Neurotology, 34(3), 396–401.
Goldinger, S. D., Pisoni, D. B., & Logan, J. S. (1991). On the nature of talker variability effects on recall of spoken word lists. Journal of Experimental Psychology: Learning, Memory, and Cognition, 17(1), 152–162.
Guérard, K., Saint-Aubin, J., Burns, S. C., & Chamberland, C. (2012). Revisiting backward recall and benchmark memory effects: A reply to Bireta et al. (2010). Memory & Cognition, 40(3), 388–407.
Gupta, P., Lipinski, J., & Aktunc, E. (2005). Reexamining the phonological similarity effect in immediate serial recall: The roles of type of similarity, category cuing, and item recall. Memory & Cognition, 33(6), 1001–1016.
Horn, D. L., Davisa, R. A., Pisoni, D. B., & Miyamoto, R. T. (2004). Visual attention, behavioral inhibition and speech/language outcomes in deaf children with cochlear implants. International Congress Series, 1273, 332–335.
Johnson, C., & Goswami, U. (2010). Phonological awareness, vocabulary, and reading in deaf children with cochlear implants. Journal of Speech, Language, and Hearing Research, 53(2), 237–261.
Kronenberger, W. G., Pisoni, D. B., Henning, S. C., & Colson, B. G. (2013). Executive functioning skills in long-term users of cochlear implants: A case control study. Journal of Pediatric Psychology, 38(8), 902–914.
Kronenberger, W. G., Xu, H., & Pisoni, D. B. (2020). Longitudinal development of executive functioning and spoken language skills in preschool-aged children with cochlear implants. Journal of Speech, Language, and Hearing Research, 63(4), 1128–1147.
Martin, C. S., Mullennix, J. W., Pisoni, D. B., & Summers, W. V. (1989). Effects of talker variability on recall of spoken word lists. Journal of Experimental Psychology: Learning, Memory, and Cognition, 15(4), 676–684.
McKeown, D., Mills, R., & Mercer, T. (2011). Comparisons of complex sounds across extended retention intervals survives reading aloud. Perception, 40(10), 1193–1205.
Mullennix, J. W., Pisoni, D. B., & Martin, C. S. (1989). Some effects of talker variability on spoken word recognition. The Journal of the Acoustical Society of America, 85(1), 365–378.
Nagy, W., & Townsend, D. (2012). Words as tools: Learning academic vocabulary as language acquisition. Reading Research Quarterly, 47(1), 91–108.
Nairne, J. S., & Crowder, R. G. (1982). On the locus of the stimulus suffix effect. Memory & Cognition, 10(4), 350–357.
Nairne, J. S., & Walters, V. L. (1983). Silent mouthing produces modality- and suffix-like effects. Journal of Verbal Learning and Verbal Behavior, 22(4), 475–483.
Nees, M. A. (2016). Have we forgotten auditory sensory memory? Retention intervals in studies of nonverbal auditory working memory. Frontiers in Psychology, 7, Article 1892.
Nittrouer, S. (2010). Early development of children with hearing loss. Plural.
Nittrouer, S., Antonelli, J., & Lowenstein, J. H. (2022). The emergence of bifurcated structure in children's language. Journal of Experimental Psychology: General, 151(12), 3045–3059.
Nittrouer, S., & Burton, L. T. (2005). The role of early language experience in the development of speech perception and phonological processing abilities: Evidence from 5-year-olds with histories of otitis media with effusion and low socioeconomic status. Journal of Communication Disorders, 38(1), 29–63.
Nittrouer, S., Caldwell-Tarr, A., Low, K. E., & Lowenstein, J. H. (2017). Verbal working memory in children with cochlear implants. Journal of Speech, Language, and Hearing Research, 60(11), 3342–3364.
Nittrouer, S., Caldwell-Tarr, A., & Lowenstein, J. H. (2013). Working memory in children with cochlear implants: Problems are in storage, not processing. International Journal of Pediatric Otorhinolaryngology, 77(11), 1886–1898.
Nittrouer, S., & Lowenstein, J. H. (2014). Separating the effects of acoustic and phonetic factors in linguistic processing with impoverished signals by adults and children. Applied Psycholinguistics, 35(2), 333–370.
Nittrouer, S., & Lowenstein, J. H. (2022). Beyond recognition: Visual contributions to verbal working memory. Journal of Speech, Language, and Hearing Research, 65(1), 253–273.
Nittrouer, S., Lowenstein, J. H., Wucinich, T., & Moberly, A. C. (2016). Verbal working memory in older adults: The roles of phonological capacities and processing speed. Journal of Speech, Language, and Hearing Research, 59(6), 1520–1532.
Nittrouer, S., & Miller, M. E. (1999). The development of phonemic coding strategies for serial recall. Applied Psycholinguistics, 20(4), 563–588.
Nittrouer, S., Sansom, E., Low, K., Rice, C., & Caldwell-Tarr, A. (2014). Language structures used by kindergartners with cochlear implants: Relationship to phonological awareness, lexical knowledge and hearing loss. Ear and Hearing, 35(5), 506–518.
Pichora-Fuller, M. K., Kramer, S. E., Eckert, M. A., Edwards, B., Hornsby, B. W., Humes, L. E., Lemke, U., Lunner, T., Matthen, M., Mackersie, C. L., Naylor, G., Philips, N. A., Richter, M., Rudner, M., Sommers, M. S., Tremblay, K. L., & Wingfield, A., (2016). Hearing impairment and cognitive energy: The Framework for Understanding Effortful Listening (FUEL). Ear and Hearing, 37, 5S–27S.
Pisoni, D. B., & Cleary, M. (2003). Measures of working memory span and verbal rehearsal speed in deaf children after cochlear implantation. Ear and Hearing, 24(1), 106S–120S.
Pisoni, D. B., & Geers, A. E. (2000). Working memory in deaf children with cochlear implants: Correlations between digit span and measures of spoken language processing. Annals of Otology, Rhinology, & Laryngology, 185, 92–93.
Roid, G. H., & Miller, L. J. (2002). Leiter International Performance Scale–Revised. Stoelting Co.
Rowe, E. J., & Rowe, W. G. (1976). Stimulus suffix effects with speech and nonspeech sounds. Memory & Cognition, 4(2), 128–131.
Rönnberg, J. (2003). Cognition in the hearing impaired and deaf as a bridge between signal and dialogue: A framework and a model. International Journal of Audiology, 42(Suppl. 1), 68–S76.
Salame, P., & Baddeley, A. D. (1986). Phonological factors in STM: Similarity and the unattended speech effect. Bulletin of the Psychonomic Society, 24(4), 263–265.
Salter, D., & Colley, J. G. (1977). The stimulus suffix: A paradoxical effect. Memory & Cognition, 5(2), 257–262.
Scarborough, H. S. (2001). Connecting early language and literacy to later reading (dis)abilities: Evidence, theory, and practice. In S. B. Neuman & D. K. Dickinson (Eds.), Handbook of early literacy research (pp. 97–110). Guilford.
Schleppegrell, M. J. (2004). The language of schooling: A functional linguistics perspective. Erlbaum.
Spoehr, K. T., & Corin, W. J. (1978). The stimulus suffix effect as a memory coding phenomenon. Memory & Cognition, 6(6), 583–589.
Tamati, T. N., Pisoni, D. B., & Moberly, A. C. (2021). The perception of regional dialects and foreign accents by cochlear implant users. Journal of Speech, Language, and Hearing Research, 64(2), 683–690.
Terhune-Cotter, B. P., Conway, C. M., & Dye, M. W. G. (2021). Visual sequence repetition learning is not impaired in signing DHH children. Journal of Deaf Studies and Deaf Education, 26(3), 322–335.
Uccelli, P., Barr, C. D., Dobbs, C. L., Galloway, E. P., Meneses, A., & Sanchez, E. (2015). Core academic language skills: An expanded operational construct and a novel instrument to chart school-relevant language proficiency in preadolescent and adolescent learners. Applied Psycholinguistics, 36(5), 1077–1109.
Werfel, K. L., & Hendricks, A. E. (2023). The contribution of phonological processing to reading and spelling in students with cochlear implants. Language, Speech, and Hearing Services in Schools, 54(3), 967–980.

Information & Authors

Information

Published In

Journal of Speech, Language, and Hearing Research
Volume 67Number 66 June 2024
Pages: 1850-1867
PubMed: 38713817

History

  • Received: Jul 27, 2023
  • Revised: Nov 9, 2023
  • Accepted: Mar 20, 2024
  • Published online: May 7, 2024
  • Published in issue: Jun 6, 2024

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Authors

Affiliations

Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville

Notes

Disclosure: The author has declared that no competing financial or nonfinancial interests existed at the time of publication.
Correspondence to Susan Nittrouer: [email protected]
Editor-in-Chief: Julie A. Washington
Editor: Emily Lund

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